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A Network Analysis of Psychiatric Symptoms in Patients With Schizophrenia Treated With Antipsychotic Polypharmacy Using Propensity Score Matching: Findings From the Research on Asian Psychotropic Prescription Patterns (REAP) Study 使用倾向评分匹配的抗精神病药物治疗精神分裂症患者精神症状网络分析:来自亚洲精神药物处方模式(REAP)研究的结果
IF 3.4 3区 医学 Q2 PSYCHIATRY Pub Date : 2025-08-18 DOI: 10.1111/appy.70005
Wen Li, Qinge Zhang, Gabor S. Ungvari, Seon-Cheol Park, Lian-Yu Chen, Kok Yoon Chee, Roy Abraham Kallivayalil, Kang Sim, Yan-Ling He, Norman Sartorius, Naotaka Shinfuku, Shih-Ku Lin, Ajit Avasthi, Sandeep Grover, Takahiro A. Kato, Chee H. Ng, Yu-Tao Xiang

Objectives

Antipsychotic polypharmacy (APP) is prevalent among patients with schizophrenia across countries in Asia. This study aimed to explore the relationships between psychiatric symptoms and APP using network analysis.

Methods

Data on nine major psychiatric symptoms and the number of prescribed antipsychotics were extracted from the fourth survey of the Research on Asian Psychotropic Prescription Patterns (REAP-AP). A network model of the nine psychiatric symptoms was constructed for patients treated with APP and antipsychotic monotherapy (APM) respectively. The interconnections between psychiatric symptoms and APP use were further analyzed using network analysis.

Results

A total of 1528 patients with schizophrenia treated with APP were matched with 1528 patients treated with APM in Asia. The top three central psychiatric symptoms in the networks of psychiatric symptoms were consistent, but in different orders for APP-treated patients (verbal aggression, hallucinations, and social/occupational dysfunction) and APM-treated patients (social/occupational dysfunction, verbal aggression, and hallucinations). Network analysis of APP and psychiatric symptoms revealed that disorganized/catatonic behavior was strongly linked with APP, followed by delusions, hallucinations, and verbal aggression.

Conclusion

Psychiatric symptoms closely associated with APP included verbal aggression, grossly disorganized/catatonic behavior, delusions, and hallucinations. For patients with schizophrenia who are primarily exhibiting such symptoms, alternative appropriate treatment strategies should be considered.

目的抗精神病药物多药(APP)在亚洲各国精神分裂症患者中普遍存在。本研究旨在通过网络分析探讨精神症状与APP之间的关系。方法从亚洲精神药物处方模式研究(REAP-AP)第四次调查中提取9种主要精神症状和抗精神病药物处方数量的数据。应用APP和单药抗精神病治疗分别建立九种精神症状的网络模型。应用网络分析进一步分析精神症状与APP使用之间的相互关系。结果亚洲地区共1528例应用APP治疗的精神分裂症患者与1528例应用APM治疗的精神分裂症患者相匹配。在精神症状网络中,前三名的中心精神症状是一致的,但app治疗的患者(言语攻击、幻觉、社会/职业功能障碍)和apm治疗的患者(社会/职业功能障碍、言语攻击、幻觉)的顺序不同。APP与精神症状的网络分析显示,紊乱/紧张性行为与APP密切相关,其次是妄想、幻觉和言语攻击。结论与APP密切相关的精神症状包括言语攻击、严重紊乱/紧张性行为、妄想和幻觉。对于主要表现出这些症状的精神分裂症患者,应考虑其他适当的治疗策略。
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引用次数: 0
Adjunctive Antidepressant Use in Bipolar Disorder and Its Clinical Correlates: An Asian Psychotropic Prescription Patterns Consortium Study 双相情感障碍中辅助抗抑郁药的使用及其临床相关性:一项亚洲精神药物处方模式联合研究
IF 2.8 3区 医学 Q2 PSYCHIATRY Pub Date : 2025-06-09 DOI: 10.1111/appy.70004
Yi Hu, Qian Hui Chew, Shih-Ku Lin, Wen-Chen Ouyang, Chih-Ken Chen, Seon-Cheol Park, Ok-Jin Jang, Kok-Yoon Chee, Kwong Sen Ding, Jamaline Chong, Ling Zhang, Keqing Li, Xiaomin Zhu, Chonnakarn Jatchavala, Pornjira Pariwatcharakul, Roy A. Kallivayalil, Sandeep Grover, Ajit Avasthi, Moin Ansari, Margarita M. Maramis, Phyo Aung Paing, Chay Hoon Tan, Yu-Tao Xiang, Mian-Yoon Chong, Yong Chon Park, Takahiro A. Kato, Naotaka Shinfuku, Ross J. Baldessarini, Kang Sim

Introduction

Adjunctive antidepressant (AD) use is prevalent for the treatment of bipolar disorder (BD) in many countries, but there is little information about this practice in Asia. Accordingly, we addressed the prevalence, dosing, and clinical correlates of adjunctive AD use with BD in a large Asian sample.

Methods

Patients with BD were recruited across 13 Asian sites (PR China, Hong Kong, India, Indonesia, Japan, South Korea, Malaysia, Myanmar, Pakistan, Singapore, Sri Lanka, Taiwan, and Thailand) for this cross-sectional study. We examined differences between patients with versus without adjunctive AD treatment. Multivariable logistic regression was used to identify factors associated with the use of adjunctive AD.

Results

Among a total of 2114 adult participants (47.7% men; age 42.4 years [CI: 41.8–43.0]; BMI 25.0 kg/m2 [24.8–25.2]), the prevalence of AD use averaged 19.8% [18.1–21.6], at a mean imipramine-equivalent dose of 113 [110–116] mg/day. Adjunctive AD use was associated with factors including older age, outpatient status, more depression, suicidal behavior, rapid cycling, and lower doses of MS and antipsychotics (APs).

Discussion

Usage of AD treatment for BD in Asia was less than half that reported in Western samples. Such use of AD treatment appeared to be well tolerated but underscores the need for close clinical follow-up to avoid risks of excessive elevation of mood or behavior.

在许多国家,辅助抗抑郁药(AD)的使用普遍用于治疗双相情感障碍(BD),但在亚洲,这方面的信息很少。因此,我们在一个大的亚洲样本中研究了辅助AD与双相障碍的患病率、剂量和临床相关性。方法在13个亚洲地区(中国、香港、印度、印度尼西亚、日本、韩国、马来西亚、缅甸、巴基斯坦、新加坡、斯里兰卡、台湾和泰国)招募BD患者进行横断面研究。我们检查了接受辅助AD治疗和未接受辅助AD治疗的患者之间的差异。使用多变量逻辑回归来确定与辅助AD使用相关的因素。结果共纳入2114名成年受试者(男性47.7%;年龄42.4岁[CI: 41.8-43.0];BMI为25.0 kg/m2[24.8-25.2]),平均丙咪嗪当量剂量为113 [110-116]mg/天,AD患病率为19.8%[18.1-21.6]。辅助AD的使用与年龄较大、门诊状态、更多抑郁、自杀行为、快速循环、MS和抗精神病药物(APs)剂量较低等因素相关。在亚洲,AD治疗双相障碍的使用率不到西方样本的一半。这种使用阿尔茨海默病治疗似乎耐受性良好,但强调需要密切的临床随访,以避免情绪或行为过度升高的风险。
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引用次数: 0
A Predictive Nomogram for Suicide Attempts in Chinese Adolescents With Both Non-Suicidal Self-Injury and Suicidal Ideation 中国青少年非自杀性自伤和自杀意念自杀企图的预测Nomogram (n形图)
IF 2.8 3区 医学 Q2 PSYCHIATRY Pub Date : 2025-04-23 DOI: 10.1111/appy.70003
Yi-Hui Liu, Ming Chen, Hao-Zhang Huang, Jia-Rong Liang, Yong-Yi He, Jia-Hui Hu, Ting-Ting Zhang, Fu-Jun Jia, Cai-Lan Hou

Introduction

Non-suicidal self-injury (NSSI) and suicidal ideation (SI) are prevalent and co-occurring among adolescents, serving as critical predictors of suicide. This study aimed to develop a predictive model and nomogram for suicide attempts (SA) in Chinese adolescents with mood disorders exhibiting NSSI and SI.

Methods

Data were collected from 134 participants. Predictors were selected via LASSO regression from data collected using the Self-Injurious Thoughts and Behaviors Interview-Revised and self-report scales, followed by multivariate logistic regression to build the nomogram. Model performance was assessed through discriminatory ability, calibration curves, and clinical decision analysis.

Results

Adolescents with SA history had fewer education years, higher prevalence and future likelihood of self-injurious thoughts and behaviors, earlier NSSI onset, more frequent and severe NSSI, and more intense and persistent SI compared to those without SA. Three key predictors for SA were identified: NSSI emotion regulation scores, average SI persistence duration, and history of interrupted attempts. The developed nomogram exhibited robust predictive accuracy with an AUC of 0.756.

Discussion

This study presents a predictive model for suicide risk in adolescents with mood disorders exhibiting NSSI and SI. The model demonstrates high predictive accuracy and clinical applicability, offering a practical tool for clinicians to prioritize high-risk cases and guide personalized interventions.

导言:非自杀性自伤(NSSI)和自杀意念(SI)在青少年中普遍存在并同时出现,是预测自杀的关键因素。本研究旨在为有情绪障碍的中国青少年建立一个自杀企图(SA)的预测模型和提名图。 方法 收集了 134 名参与者的数据。根据自伤想法和行为访谈-修订版及自我报告量表收集的数据,通过LASSO回归筛选出预测因子,然后通过多元逻辑回归建立提名图。通过判别能力、校准曲线和临床决策分析对模型性能进行评估。 结果 与无 SA 史的青少年相比,有 SA 史的青少年受教育年限更短、自伤想法和行为的发生率和未来可能性更高、NSSI 开始得更早、NSSI 更频繁和更严重、SI 更强烈和更持久。研究发现了三个预测 SA 的关键因素:NSSI情绪调节评分、SI持续平均持续时间和中断尝试史。所开发的提名图具有很高的预测准确性,AUC 为 0.756。 讨论 本研究提出了一种情绪障碍青少年自杀风险预测模型,该模型表现出 NSSI 和 SI。该模型具有很高的预测准确性和临床适用性,为临床医生优先处理高风险病例和指导个性化干预提供了实用工具。
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引用次数: 0
Sexsomnia-Like Behaviors Associated With Zolpidem 唑吡坦与嗜睡性行为有关
IF 2.8 3区 医学 Q2 PSYCHIATRY Pub Date : 2025-02-25 DOI: 10.1111/appy.70002
Hui-Yuan Liao, Huang-Chi Lin
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引用次数: 0
Emergence of a New Threat in East Asia: Severe Agitation and Suicide Attempts Linked to Etomidate-Infused E-Cigarettes 东亚新威胁的出现:与注入乙胺咪酯的电子烟有关的严重躁动和自杀企图
IF 2.8 3区 医学 Q2 PSYCHIATRY Pub Date : 2025-02-13 DOI: 10.1111/appy.70001
Chun-I Liu, I-Ming Chen, Szu-Yung Wang, Chi Chen
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引用次数: 0
A Comparative Analysis of Neurological Soft Signs and Emotional Intelligence in Rapid Cycling and Non-Rapid Cycling Bipolar Disorder 快速循环与非快速循环双相情感障碍的神经软体征及情绪智力比较分析
IF 2.8 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-11-28 DOI: 10.1111/appy.70000
Feng Yingying, Yang Bo, Zhao Jun

Background

Rapid cycling (RC) is a special subtype of bipolar disorder (BD). Previous studies have rarely involved the investigation of neurological soft signs (NSS) and emotional intelligence (EI) in rapid cycling patients.

Object

This study aims to compare the differences in NSS and EI between patients with RC and non-rapid cycling (NRC) in BD.

Methods

The Cambridge Neurological Inventory and The Mayer–Salovey–Caruso Emotional Intelligence Test were used to assess the NSS and EI levels of euthymic patients with BD and healthy controls (HC). Patients were divided into RC and NRC groups.

Results

In terms of NSS, both the RC and NRC groups scored significantly higher than the HC group in the Motor coordination subdomain and total scores. In the Sensory integration subdomain, there was a significant trend of RC group scoring higher than the NRC group, which in turn scored higher than the HC group. In terms of EI, there was a trend of RC group scoring lower than the NRC group, which scored lower than the HC group in the understanding emotions subdomain and MSCEIT total score. In the managing emotions subdomain, the RC group scored lower than the HC group.

Conclusion

Compared to the NRC group, the RC group exhibited higher NSS levels, mainly manifesting in more severe sensory integration impairment. The RC group scored lower in EI, primarily reflected in understanding and managing emotions, and the managing emotions subdomain may serve as a more sensitive indicator to distinguish between the two groups.

快速循环(RC)是双相情感障碍(BD)的一种特殊亚型。以往的研究很少涉及对快速循环患者的神经软体征(NSS)和情绪智力(EI)的调查。目的比较BD患者与非快速循环(NRC)患者NSS和EI水平的差异。方法采用剑桥神经量表和Mayer-Salovey-Caruso情绪智力测验评估健康BD患者和健康对照(HC)的NSS和EI水平。患者分为RC组和NRC组。结果在NSS方面,RC组和NRC组在运动协调子域和总分上均显著高于HC组。在感觉统合子域上,RC组得分高于NRC组,NRC组得分又高于HC组。在情商方面,RC组得分低于NRC组,NRC组在理解情绪子领域和MSCEIT总分上得分低于HC组。在情绪管理子领域,RC组得分低于HC组。结论与NRC组相比,RC组NSS水平较高,主要表现为感觉统合障碍加重。RC组的EI得分较低,主要体现在理解和管理情绪方面,情绪管理子域可能是区分两组的一个更敏感的指标。
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引用次数: 0
Cross-Cultural Differences in the Pathways to Internet Gaming Disorder 导致网络游戏障碍的跨文化差异。
IF 2.8 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-10 DOI: 10.1111/appy.12565
Peter K. H. Chew, Patrick K. F. Lin, Yong Jie Yow

Background

No research to date has examined cross-cultural differences in the pathways to internet gaming disorder (IGD). The current study aimed to address this limitation by examining the relationships between nationality (Singaporeans vs. Australians), culture orientation, gaming motivations, and IGD.

Methods

Participants were 101 Singaporeans (55.4% males) and 98 Australians (52.0% males). They completed the Culture Orientation Scale, the Motives for Online Gaming Questionnaire, and the Internet Gaming Disorder Scale-Short-Form.

Results

A series of mediational analyses showed that Singaporeans tend to be more collectivistic (both horizontally and vertically). In turn, this culture orientation motivates them to play games for social reasons, increasing the risk for IGD. In contrast, Australians tend to be more individualistic (vertically only). In turn, this culture orientation motivates them to play games for competitive reasons, increasing the risk for IGD.

Conclusion

Limitations include the use of samples from two countries only, precluding a generalization of the results. Future research directions include examining the role of game genres as a mediator in the nationality-IGD relationship.

背景:迄今为止,还没有研究探讨过网络游戏障碍(IGD)的跨文化差异。本研究旨在通过考察国籍(新加坡人与澳大利亚人)、文化取向、游戏动机和 IGD 之间的关系来解决这一局限性:参与者包括 101 名新加坡人(55.4% 为男性)和 98 名澳大利亚人(52.0% 为男性)。他们填写了文化取向量表、网络游戏动机问卷和网络游戏障碍量表-简表:一系列中介分析表明,新加坡人更倾向于集体主义(横向和纵向)。反过来,这种文化取向促使他们出于社交原因玩游戏,从而增加了患 IGD 的风险。相比之下,澳大利亚人更倾向于个人主义(仅纵向)。反过来,这种文化取向促使他们出于竞争原因玩游戏,从而增加了患 IGD 的风险:研究的局限性包括研究样本仅来自两个国家,因此无法将研究结果普遍化。未来的研究方向包括研究游戏类型在民族-IGD 关系中的中介作用。
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引用次数: 0
Bipolar disorder and oxidative stress: A bibliometric perspective 躁郁症与氧化应激:文献计量学视角。
IF 2.8 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-08-13 DOI: 10.1111/appy.12564
Zhen Gui PhD, Qinge Zhang MD, Sha Sha MD, Xiao-Hong Li MD, Zhaohui Su PhD, Teris Cheung PhD, Xi-Ling Cui PhD, Gabor S. Ungvari MD, PhD, Katrine K. Wong PhD, Chee H. Ng MBBS, MD, Feng Yuan MD, Yu-Tao Xiang MD, PhD

Objective

Accumulating evidence indicates that oxidative stress and the disruption of antioxidant defenses play an important role in the neurobiology of bipolar disorder (BD). Studies have found that increased oxidative stress may be associated with cell apoptosis and neuronal damage in BD patients. Hence, this study explored the research field related to BD and oxidative stress from a bibliometrics perspective.

Methods

Literature search and relevant data retrieval based on the Web of Sciences Core Collection (WoSCC). R software (version 4.2.2), VOSviewer software (version 1.6.18), and CiteSpace (version 6.1.6) were used in this bibliometric analysis.

Results

A total of 2081 publications related to BD and oxidative stress were published between 1986 and 2024. Bipolar Disorders was the journal that had the most publications in this area (72; 3.46%; IF = 5.9), while the United States (1285; 61.7%) and the University of Toronto (377; 18.1%) were the most productive country and institution, respectively. Apart from “oxidative stress” and “bipolar disorder,” the most frequently used keywords were “schizophrenia,” “prefrontal cortex,” and “nitric oxide.”

Conclusions

The growing number of publications related to BD and oxidative stress in recent years highlights the importance of this research field. Hot topics in research related to BD and oxidative stress included animal experiments and molecular mechanisms, psychiatric-related inflammation and biomarkers, neurodegenerative diseases, and metabolism. Furthermore, the biological mechanisms of BD, particularly biomarkers and inflammation, may be the emerging research priority area in the future.

目的:越来越多的证据表明,氧化应激和抗氧化防御系统的破坏在双相情感障碍(BD)的神经生物学中起着重要作用。研究发现,氧化应激的增加可能与双相情感障碍患者的细胞凋亡和神经元损伤有关。因此,本研究从文献计量学的角度探讨了与双相情感障碍和氧化应激相关的研究领域:文献检索和相关数据检索基于 Web of Sciences Core Collection (WoSCC)。文献计量学分析使用了 R 软件(4.2.2 版)、VOSviewer 软件(1.6.18 版)和 CiteSpace(6.1.6 版):结果:1986 年至 2024 年间,共发表了 2081 篇与 BD 和氧化应激相关的论文。双相情感障碍》是该领域发表论文最多的期刊(72篇;3.46%;IF=5.9),而美国(1285篇;61.7%)和多伦多大学(377篇;18.1%)分别是发表论文最多的国家和机构。除 "氧化应激 "和 "双相情感障碍 "外,最常使用的关键词是 "精神分裂症"、"前额叶皮质 "和 "一氧化氮":近年来,与躁狂症和氧化应激相关的论文数量不断增加,凸显了这一研究领域的重要性。与 BD 和氧化应激相关的研究热点包括动物实验和分子机制、精神相关炎症和生物标志物、神经退行性疾病和新陈代谢。此外,BD 的生物学机制,尤其是生物标志物和炎症,可能是未来新兴的研究重点领域。
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引用次数: 0
Optimizing esketamine clinic implementation: Insights from Taiwan's mental health framework 优化艾司氯胺酮诊所的实施:台湾心理健康框架的启示。
IF 2.8 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-08-05 DOI: 10.1111/appy.12563
Lien-Chung Wei MD, MPH, Li-Fen Chen MD, MPH
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引用次数: 0
Letter to the editor—Reflections on “Total valproate versus free valproate in therapeutic drug monitoring for bipolar disorder: A cross-sectional study” 致编辑的信--对 "丙戊酸总量与游离丙戊酸在双相情感障碍治疗药物监测中的对比:一项横断面研究"。
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-06-17 DOI: 10.1111/appy.12562
Lien-Chung Wei MD, MPH, Happy Kuy-Lok Tan MD, MPH, MHS
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引用次数: 0
期刊
Asia‐Pacific Psychiatry
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